Following breast surgeries, surgeries inside the chest and in particular surgeries requiring access through the sternum bone (sternotomy), women in general and fuller-sized women in particular, as well as obese patients, encounter additional pain and wound healing complications, caused by the weight of the breast tissue. The mass of breast tissue causes the gravity force to pull the breast tissue downwards when a person is in the standing position and to the lateral sides when a person is in the horizontal position or leaning back. Such pulling force causes significant stress on a fresh surgical wound and in particular on a fresh sternal wound. The two wound edges will be drawn away from each other by the weight pull, and the sutures may break through the skin and wound edges, causing the wound to break open. An open or partially open wound will increase the rate of wound infections, wound deformations, deeper wound rupture and cause additional pain. In an even worse scenario, the pulling force from heavy breast tissue causes the sternum sutures, typically made of stainless steel, to cut into or through the sternum bone. This will cause pain, deep sternal wound infections and sternum dehiscence, which are very severe post operative complications that are very costly to cure.
Therefore breast tissue, and in particular fuller-sized breast tissue, must be positioned and supported to prevent gravity pulling forces in any direction on a wound in the chest and in particular a sternal wound. Simultaneously, as the pulling force is controlled, the breast tissue must not squeeze the wound, and in particular the breast tissue must not squeeze a sternal wound from the lateral sides. Such squeezing pressure on a wound will generate heat and moisture, which both can cause bacterial growth and result in severe infections. Additionally, squeezing a wound, and in particular a sternal wound, disturbs the natural healing process, and the result is deformation of the wound, which leaves an esthetically, unattractive scar in a highly visible place on a patient's chest. This may be a psychological problem for the patient postoperatively, and in particular, it may be a psychological problem for women postoperatively.
Inspection and care of a fresh surgical wound requires access to the wound by opening of the dressings, bands and brassieres, which may cover the wound. This represents particularly a problem for obese patients and fuller sized women, since the support of breast tissue is interrupted during such wound exposure. The gravity force will pull and cause stress on the wound during care, whereby the rate of postoperative complications may increase. Therefore support of the breasts must be maintained at all times during wound inspection and care to prevent such complications and the related increased costs of cure.
A surgical chest dressing is described in U.S. Pat. No. 6,135,975 to Johnstone which incorporates by reference U.S. Pat. No. 3,968,803 to Hyman; U.S. Pat. No. 5,152,741 to Farnio; and U.S. Pat. No. 5,538,502 to Johnstone. The described chest dressing is a brassiere directed towards improved support and comfort of the chest dressings and is “designed to improved support for a patient by holding the breasts of the patient relatively immobile while pressing them slightly toward the line of the incision”. However, the surgical chest dressing described is squeezing a patient's side and breast tissue towards the center, whereby a wound in the thoracic area, and in particular a sternal wound, will be exposed to excessive pressure and heat-moist generation from the two breasts being pressed towards each other causing discomfort and pain for a woman with a fresh surgical wound, and in particular for obese and fuller-sized women. Such excessive pressure, heat-moist generation will result in increased potential for wound infections and other complications related to wound healing, as well as scar deformation. These are all complications that will lead to increased health care costs as well.
U.S. Pat. No. 4,804,351 to Rami et al. describes a surgical brassiere directed towards reducing stress along the mid-sternal incision line. The device has a pair of bust support cups and a ventilated panel over the gap between the cups. The ventilated panel can be opened for wound care and discloses how “a pair of inner straps, detachably secured across the gap between the bust support cups, assure that support continues to be provided while the ventilated panel is thus unsecured”. However, while the brassiere may remain closed during wound care, there is no means to position the breast tissue to prevent gravitation to the sides, or to prevent the breast cups to squeeze the breast tissue towards the center. This will cause extra pulling stress and/or squeezing on a sternal wound and cause discomfort and pain for a patient, and in particular for obese patients and fuller-sized women. Such wound stress can result in increased infection and complication rates, which will lead to increased health care costs when treating such complications.
U.S. Pat. No. 5,797,786 to Smith et al. describes a post operative brassiere that has been “developed to provide a post-operative brassiere which completely eliminates the conventional torso straps that interconnect the bust support cups so as to form an exposed gap over the area of the patient's mid-sternal incision line to help promote healing and recovery”. However, the brassiere has no means to stabilize the breast support cups and prevent gravitation to the sides or to prevent squeezing of the breast tissue towards the center. This will cause pulling stress and/or squeezing on a sternal wound and cause pain and discomfort for a fuller-sized woman, and in particular for obese patients. Such wound stress results in increased infection and complication rates, which will lead to increased health care costs when treating such complications.
Sports bras and brassieres for athletic use generally aim at supporting and immobilizing the breasts to allow women to perform sports activities in a comfortable and painless way. Some of these brassieres are devoted to women with a large bust, such as U.S. Pat. No. 5,221,227 to Michels and U.S. Pat. No. 6,165,045 to Miller et al. Sports brassieres are sometimes employed to patients post-operatively for breast support. However, since they are designed for sports activities, they are generally not suitable for postoperative use and do not meet the specific needs both patients and health care personnel require after surgery.
A brassiere for strenuous physical activity is described in U.S. Pat. No. 4,254,777 to Johnston and shows the use of “extra facings” around the bra cups to prevent undue movement of the breasts. These “facings” have no means to be adjusted and are too thin to give support or direct the position of a breast.
A number of compression brassieres are available for use post-operatively for surgeries such as breast augmentation, reconstructive breast surgeries and other surgeries in the breast(s). Such compression brassieres have drawbacks and are not suitable for postoperative use after interventions inside the thorax, e.g. cardiothoracic surgery, since these devices are designed to compress the breast tissue with the aim to eliminate or reduce swelling caused by accumulation of lymph fluids after a surgical intervention in the breast(s), and/or to press downward newly inserted breast implants. A drawback for cardiothoracic patients using compression brassieres is that the breast tissue is compressed inwards, thereby squeezing and spreading the breast tissue over the thoracic wall in all directions. Such compression is very uncomfortable and painful and may cause healing complications for the wound, and in particular for a sternal wound, which will be exposed to undesirable high pressure and heat-moisture generation. This will increase the rate of wound infections and wound deformations. In particular, such undesirable high pressure on a sternal wound will increase the rate of wound complications in obese patients and for fuller-sized women. All postoperative complications lead to increased health care costs, when they need to be treated.
Examples of prior art for a compression and post-partum breast engorgement bra are described in U.S. Pat. No. 5,839,942 to Miller and other compression devices are disclosed in U.S. Pat. No. 5,098,331 to Corrado; U.S. Pat. No. 5,037,348 to Farino; and U.S. Pat. No. 7,144,294 B2 to Bell et al.
A compression bra is described specifically for symmastia in U.S. Pat. No. 7,666,058 B2 to Smith. This design is directed towards a “compression stabilizing, supporting and positioning bra for addressing and/or correcting synmastia complications in reconstructive breast surgeries . . . ” and has a “flared, trapezoidal shaped, sternum compression panel secured at its base to the upper edge of the torso band below the inframammary skinfold and at the top, by a pair of adjustable shoulder straps for elastically compressing sternum tissues while restraining shaping and separating the inside conically rising, side portions of a woman's breasts”. While the device described obviously cannot be utilized for patients having had a sternotomy, it aims at “supporting and positioning” the breasts. However, there is no means to prevent gravitation of the breast tissue to the central or the lateral sides. Furthermore, the adjustable shoulder straps that are attached to a panel for elastically compressing the sternum tissue between a woman's breasts only pull a panel upwards and cannot support or direct a breast in any direction.
In view of the foregoing, it is a general object of the present invention to provide a brassiere that can improve the postoperative care and experience for patients, decrease postoperative complications and thereby costs of health care.
A further object of the present invention is to provide a breast-supportive brassiere for obese patients and fuller-sized women who have had surgery in the thoracic region, surgery in the breasts, such as breast augmentation or reconstruction, surgery inside the chest, and in particular surgery that require a mid-sternal incision (sternotomy).
Another object of the present invention is to provide a breast-positioning brassiere for obese patients and fuller-sized women who have had said type of surgeries.
It is yet another object of the present invention to provide a brassiere that prevents gravitation of the patient's breast tissue to the lateral sides when the patient is lying down in a horizontal position or leaning back, in order to prevent pain and complications from weight pull on the wound.
It is yet another object of the present invention to provide a brassiere that prevents the breast tissue of the wearer to be squeezed towards each other centrally, in order to prevent pain and wound healing complications.
It is yet another object of the present invention to provide a brassiere that gives an up-lifting support to the wearer's breast tissue in order to prevent pain and wound healing complications from weight pull on the wound.
It is yet another object of the present invention to provide a brassiere where the position of each breast can be adjusted separately in order to adapt the brassiere optimally to each individual patient's figure.
It is yet another object of the present invention to provide a brassiere that can be adjusted separately for the lateral, the central and the up-lifting support of each breast in order to adapt the brassiere optimally to all various incisions used in different surgeries.
It is yet another object of the present invention to provide a brassiere that maintains the lateral and central support to each breast during wound inspection and care.
It is yet another object of the present invention to provide a brassiere that is easy to open and to close after wound inspection and care.
It is yet another object of the present invention to provide a brassiere that is easy to open in emergency situations that require direct access to the patient's chest.
It is yet another object of the present invention to provide a brassiere that maintains a woman's dignity by keeping the breasts covered during wound inspection and care, which particularly may be an issue for patients of different ethnic origins.
It is yet another object of the present invention to provide a brassiere that is light and does not promote sweating.
It is also an object of the present invention to provide a brassiere that is comfortable to use for the wearer.